I am so honored to be able to be the guest editor for this issue of Ophthalmology Management. With Dr. Neda Shamie’s expert guidance, we have been able to curate a compelling series of articles focused on corneal diagnostics and disease management.
To be at the top of our game, clinicians and surgeons need precise diagnostics as well as effective therapeutics to treat our patients with complex corneal and ocular surface pathology. I am constantly awed at the speed with which innovation takes place in the cornea and ocular surface arena and am fortunate that I have so many tools and treatments at my fingertips for my patients.
IMAGING TECHNOLOGIES
As a corneal specialist, the first thing I look at before walking into a patient’s exam room is their corneal topography and tomography images. These images are invaluable as they help me diagnose pathologies before even examining the patient at the slit lamp and help guide my decision making for cataract, corneal and refractive surgery.
Our cover feature highlights how integral corneal imaging devices are to navigate our world of corneal and ocular surface diseases, and Drs. Hura, Schallhorn, Houser and Nattis weigh in on the ways they utilize these technologies.
Once we have excellent diagnostic images and have arrived at the correct diagnosis, it is up to us to synthesize this information and produce a treatment plan for our patients. Dr. Neda Nikpoor discusses her thought processes on how to approach cataract surgery in patients with irregular corneas and the IOL options she considers for each of these patients. These cases are certainly not run of the mill, and performing a thorough preoperative workup with diagnostic testing, providing in-depth vision expectation counseling and offering appropriate IOL choices are all critical for success.
CHANGING THE WAY WE TREAT PATIENTS
Dr. W. Barry Lee give us an overview of the emerging advances in corneal transplantation, including advanced artificial corneas and injectable endothelial cells, which can change the way we treat corneal disease. It is humbling to think that the techniques we mastered in training, such as full thickness and partial thickness corneal transplantation, may soon be supplanted by new, less invasive treatments.
Dr. Matthew Wade discusses the importance of diagnosing and treating keratoconus and post-refractive corneal ectasias. He busts myths and misconceptions about when to treat these conditions and provides insights on how to weave collagen crosslinking into your practice infrastructure and build your patient base. Crosslinking has been a paradigm shift in how we treat patients, and the advancements of epithelium-off crosslinking techniques can further augment the uptake and success of this procedure.
Dr. Neel Desai and Bryan Adams describe the exciting advancements in regenerative medicine as applied to ocular surface disease with the advent of novel dehydrated amniotic membrane products as well as the use of longstanding cryopreserved amniotic membranes to facilitate ocular surface optimization and rehabilitation.
We also cover Fortisite (Harrow), a new compounded antibiotic formulation that can be stored in-office to help patients with corneal ulcers have expedient access to potent antimicrobial therapies in the setting of sight-threatening keratitis. Drs. Eric Donnenfeld and Brian Shafer share their experiences on how implementation of this in-office compounded medication has filled an unmet need in their practices.
CONCLUSION
I think you will love this issue as much as I do and will come away with more insights of what new tools and treatments to add to your clinical practice and appreciations for the ongoing, dynamic advancements in this field. Enjoy! OM
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